Claim total
$1,153.72
base $93.83 · payer covered $1,103.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-10-24
- Stop
- 1985-10-24
The parties
- Patient
- patient Marci Floy Osinski
- Provider
- provider Ignacio Paredes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
15120c17-c8d7-3c84-96c3-2111326c0d3d